Effect of electromyography biofeedback treatment on reaction time, pain, hand grip strength, and upper extremity functional status in patients with carpal tunnel syndrome.

Yıl 2023, Cilt: 48 Sayı: 1, 261 - 267, 31.03.2023

Rukiye Çiftçi , Ahmet Kurtoğlu , Kahraman Özgür Çelebi

https://doi.org/10.17826/cumj.1227932

Öz

Purpose: The aim of the study was to investigate the effect of electromyography biofeedback (EMG-BF), which in addition to conventional electrophysical therapy (EPT) commonly used in the symptomatic treatment of carpal tunnel syndrome (CTS), on motor parameters such as strength and reaction time and symptomatic functional parameters such as pain and function of the upper extremity.
Materials and Methods: Patients diagnosed with CTS were divided into two groups. The first group was the conventional EPT group only (control group, n=46 hands), and the second group was the group that received EMG-BF in addition to the conventional EPT treatment (research group, n=42 hands). The pain (VAS), hand grip strength (HGS), audio-visual reaction time (ART-VRT), and upper extremity disability (Quick DASH) of patients in both groups were assessed before and after the treatment program.
Results: After treatment, VRT, ART, HGS, and Quick DASH were significantly better in favor of the EPT +EMG- BF group. Before treatment, resting state (VASr), mobile state (VASm), and night state (VASn) VAS values were similar between the two groups. After training, the VAS -values were better in favor of the EPT +EMG- BF –group.
Conclusion: Although EPT applications provide effective results in the rehabilitation of CTS, EMG-BF applications together with EPT applications provide more meaningful results in the rehabilitation process.

Anahtar Kelimeler

Carpal Tunnel Syndrome, electrophysical therapy, electromyography-biofeedback

Destekleyen Kurum

This study was funded by Bandirma Onyedi Eylul University Scientific Research Projects Coordination Unit

Proje Numarası

with 22-1004-005 project code.

Teşekkür

Tkanks.

Karpal tünel sendromlu hastalarda elektromyografi biofeedback tedavisinin reaksiyon süresi, ağrı, el kavrama gücü ve üst ekstremite fonksiyonel durum üzerine etkisi

Öz

Amaç: Çalışma Karpal Tünel Sendromu (CTS) semptomatik tedavisinde sıklıkla kullanılan konvansiyonel elektrofiziksel ajanlara (EPT) ek uygulanan Elektromyografi Biyo Feedback (EMG-BF)’nin kuvvet ve reaksiyon zamanı gibi motorik parametreler ve ağrı, üst ekstremite fonksiyonu gibi semptomatik-fonksiyonel parametrelere etkisini incelemeyi amaçlamıştır.
Gereç ve Yöntem: CTS tanısı alan hastalar iki gruba ayrıldı. Birinci grup sadece konvansiyonel EPT grubu (kontrol grubu, n=46 el), ikinci grup konvansiyonel EPT’ye ek EMG-BF uygulanan grup (araştırma grubu, n=42 el) olarak belirlendi. Her iki grupta hastaların tedavi programı öncesi ve sonrası ağrı (VAS), Hand Grip Strenght (HGS), görsel-işitsel reaksiyon zamanı (VRT-ART) ve üst ekstremite dizabilite (Quick DASH) durumu değerlendirildi.
Bulgular: Tedavi sonrasında VRT, ART, HGS ve Quick DASH skorları EPT+EMG-BF grubu lehine anlamlı düzeyde daha iyiydi. Tedavi öncesinde dinlenik (VASr), hareketli (VASm) ve gece (VASn) VAS skorları iki grup arasında benzerdi. Egzersiz sonrasında VAS skorları EPT+EMG-BF grubu lehine daha iyiydi.
Sonuç: Araştırmamızda; CTS rehabilitasyonunda EPT uygulamaları etkin sonuçlar vermesine rağmen, EPT uygulamalarıyla birlikte kullanılan EMG-BF uygulamaları rehabilitasyon sürecinde daha anlamlı sonuçlar verdiği tespit edilmiştir.

Anahtar Kelimeler

Elektromiyografi biofeedback, elektrofiziksel tedavi, karpal tünel sendromu

Proje Numarası

with 22-1004-005 project code.

Kaynakça

• Şimşek AT, Karaaslan N. The roles of matrix metalloproteinase-3, 8, 13 enzymes in transcarpal ligament hypertrophy in carpal tunnel syndrome. Merit Research Journal of Medicine and Medical Sciences. 2018;6:248-56.
• Chammas M, Boretto J, Burmann LM, Ramos RM, Santos Neto FCD, Silva JB. Carpal tunnel syndrome-Part I (anatomy, physiology, etiology and diagnosis). Rev. Bras. Ortop. 2014;49:429-36.
• Kaymak B, Özçakar L. Carpal tunnel syndrome. Acta Medica. 2007;38:141-6.
• Serarslan Y, Melek İM, Duman T. Carpal tunnel syndrome. Pamukkale Tıp Dergisi. 2008;1:45-9.
• Kürklü M, Türkkan S, Tüzün HY. Carpal tunnel syndrome and other entrapment neuropathies of the median nerve. TOTBİD Dergisi. 2015;14:566-71.
• Srikanteswara PK, Cheluvaiah JD, Agadi JB, Nagaraj K. The relationship between nerve conduction study and clinical grading of carpal tunnel syndrome. J Clin Diagnostic Res. 2016;10:13.
• Zamborsky R, Kokavec M, Simko L, Bohac M. Carpal tunnel syndrome: symptoms, causes and treatment options. Literature reviev. Ortop Traumatol Rehabil. 2017;19:1-8.
• Uzunca K. İnmeli hastalarda EMG biofeedback kullanımı. Türk Fiziksel Tıp Rehabilitasyon Dergisi. 2007;53(Suppl 1):26-9.
• Andrasik F. Biofeedback in headache: an overview of approaches and evidence. Cleve Clin J Med. 2010;77:72-6.
• Lim O-b, Kim J-a, Song S-j, Cynn H-s, Yi C-h. Effect of selective muscle training using visual EMG biofeedback on infraspinatus and posterior deltoid. J Hum Kinet. 2014;44:83.
• Son Jİ, Lim OB, Han HI, Cynn HS, Yi CH. Selective muscle activation with visual electromyographic biofeedback during scapular posterior tilt exercise in subjects with round-shoulder posture. Phys Ther Korea. 2015;22:17-26.
• Dickstein R, Hocherman S, Amdor G, Pillar T. Reaction and movement times in patients with hemiparesis for unilateral and bilateral elbow flexion. Phys Ther. 1993;73:374-80.
• Bunce D, MacDonald SW, Hultsch DF. Inconsistency in serial choice decision and motor reaction times dissociate in younger and older adults. Brain Cogn. 2004;56:320-7.
• Paker N, Alp M, Bardak An, Buğdayci D, Sabirli F, Ersoy S. Evaluation of wrist range of motion and hand grip strength in women with the diagnosis of carpal tunnel syndrome: A controlled study. Fiziksel Tıp ve Rehabilitasyon Bilimleri Dergisi. 2020;23:57-61
• WHO. Committee Physical Status: The Use and Interpretation of Anthopometry: Report of a WHO Expert Committee. Geneva, WHO Technical Report Series, 1995.
• Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: Visual analog scale for pain (vas pain), numeric rating scale for pain (nrs pain), mcgill pain questionnaire (mpq), short‐form mcgill pain questionnaire (sf‐mpq), chronic pain grade scale (cpgs), short form‐36 bodily pain scale (sf‐36 bps), and measure of intermittent and constant osteoarthritis pain (icoap). Arthritis Care Res (Hoboken). 2011;63(Suppl 11):S240-52.
• Koldas Dogan S, Ay S, Evcik D, Baser O. Adaptation of Turkish version of the questionnaire quick disability of the arm, shoulder, and hand (quick dash) in patients with carpal tunnel syndrome. Clin. Rheumatol. 2011;30:185-91.
• Bohannon RW, Schaubert KL. Test–retest reliability of grip-strength measures obtained over a 12-week interval from community-dwelling elders. J Hand Ther. 2005;18:426-8.
• Gavkare AM, Surdi AD, Nanaware NL. Auditory reaction time, visual reaction time and whole body reaction time in athletes. 2013.
• Bélanger A. Evidence-based Electrotherapy. Baltimore, Lippincott, 2008.
• Cohen J. Statistical Power Analysis for The Behavioral Sciences. New York, Routledge, 2013.
• Szabo RM, Slater RR Jr, Farver TB, Stanton DB, Sharman WK. The value of diagnostic testing in carpal tunnel syndrome. J Hand Surg Am. 1999;24:704-14.
• Turhanoğlu AD, Beyazova M. Reaction time and movement time in patients with carpal tunnel syndrome: an electromyographic study. Clin Biomech. 2003;18:380-4.
• Robbins H. Anatomical study of the median nerve in the carpal tunnel and etiologies of the carpal-tunnel syndrome. J Bone Joint Surg Am. 1963;45:953-66.
• Lowe BD. Effect of carpal tunnel syndrome on grip force coordination on hand tools. Ergonomics. 1999;42:550-64.
• Karcioglu O, Topacoglu H, Dikme O, Dikme O. A systematic review of the pain scales in adults: which to use? Am J Emerg Med. 2018;36:707-14.
• Koca I, Boyaci A, Tutoglu A, Ucar M, Kocaturk O. Assessment of the effectiveness of interferential current therapy and TENS in the management of carpal tunnel syndrome: a randomized controlled study. Rheumatol. Int. 2014;34:1639-45.
• Oztas O, Turan B, Bora I, Karakaya MK. Ultrasound therapy effect in carpal tunnel syndrome. Arch Phys Med Rehabil. 1998;79:1540-4.
• Bakhtiary AH, Rashidy-Pour A. Ultrasound and laser therapy in the treatment of carpal tunnel syndrome. Aust J Physiother. 2004;50:147-51.
• Duarte-Moreira RJ, Castro KVF, Luz-Santos C, Martins JVP, Sá KN, Baptista AF. Electromyographic biofeedback in motor function recovery after peripheral nerve injury: an integrative review of the literature. Appl Psychophysiol Biofeedback. 2018;43:247-57